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Prescription and Over-the-Counter Drug Facts

Busting the myths and misconceptions about prescription drug abuse

There's a reason that prescription drugs are intended to be taken under the direction of a doctor: if used improperly they can be dangerous. Teens are making the decision to abuse prescription medicines based on misinformation. In fact, many people think that abusing prescription drugs is safer than abusing illicit drugs such as heroin. As the facts will tell you, prescription drugs can have dangerous short- and long-term health consequences when used incorrectly or by someone other than for whom they were intended.

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"Facts on Prescription and Over-the-Counter Drugs" is part of a series of fact sheets from the National Institute on Drug Abuse (NIDA) that are designed to inform students, parents, educators, and mentors about the harmful effects of prescription drug abuse.

Prescription Drug Abuse

What is prescription drug abuse?

Prescription drug abuse is when someone takes a prescription drug that was prescribed for someone else or in a manner or dosage other than what was prescribed. Abuse can include taking a friend's or relative's prescription to get high, to treat pain, or because you think it will help with studying.

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What are the most commonly abused prescription and over-the-counter drugs?

Opioids (such as the pain relievers OxyContin and Vicodin), central nervous system depressants (e.g., Xanax, Valium), and stimulants (e.g., Ritalin, Adderall) are the most commonly abused prescription drugs.1 Some drugs that are available without a prescription—also known as over-the-counter drugs—also can be dangerous if they aren't taken according to the directions on the packaging. For example, DXM (dextromethorphan), the active cough suppressant found in many over-the-counter cough and cold medications, sometimes is abused, particularly by youth.

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Teens and Prescription Drugs

How many teens abuse prescription drugs?

Among youth who are 12 to 17 years old, 7.4 percent reported past-year nonmedical use of prescription medications. According to the 2011 Monitoring the Future survey, prescription and over-the-counter drugs are among the most commonly abused drugs by 12th graders, after alcohol, marijuana, and tobacco. Youth who abuse prescription medications are also more likely to report use of other drugs.

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Where do teens get prescription drugs?

The majority of both teens and young adults obtain prescription drugs they abuse from friends and relatives, sometimes without their knowledge. And in one survey, 51 percent of high school seniors said that opioid drugs other than heroin (e.g., Vicodin) would be fairly or very easy to get.2

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Why do teens abuse prescription drugs?

Teens abuse prescription drugs for a number of reasons, including to get high, to treat pain, or because they think it will help them with school work. Interestingly, boys and girls tend to abuse some types of prescription drugs for different reasons. For example, boys are more apt to abuse prescription stimulants to get high, while girls tend to abuse them to stay alert.

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Prescription Drug Abuse Effects

What happens when you abuse prescription drugs?

Abusing prescription drugs can have negative short- and long-term health consequences.3 Stimulant abuse can cause paranoia, dangerously high body temperatures, and an irregular heartbeat, especially if stimulants are taken in high doses or in ways other than in pill form.3 The abuse of opioids can cause drowsiness, nausea, constipation, and, depending on the amount taken, slowed breathing. Abusing depressants can cause slurred speech, shallow breathing, fatigue, disorientation, lack of coordination, and seizures (upon withdrawal from chronic abuse). Abuse of any of these substances may result in addiction.3

Abusing over-the-counter drugs that contain DXM—which usually involves taking doses much higher than recommended for treating coughs and colds—can impair motor function (such as walking or sitting up); produce numbness, nausea, and vomiting; and increase heart rate and blood pressure.

Abusing any type of mind-altering drug can affect judgment and inhibition and may put a person at heightened risk for HIV and other sexually transmitted diseases (STDs).

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Aren't prescription drugs safer than illegal drugs, such as cocaine or heroin?

No. Many people think that abusing prescription drugs is safer than abusing illicit drugs like heroin because the manufacturing of prescription drugs is regulated or because they are prescribed by doctors. But that doesn't mean these drugs are safe for someone other than the person with the prescription to use. Many prescription drugs can have powerful effects in the brain and body—and people sometimes take them in ways that can be just as dangerous (e.g., crushing pills and snorting or injecting them) as illicit drug abuse. In fact, opioid painkillers act on the same sites in the brain as heroin, which is one reason why they can be so dangerous when abused. Also, abusing prescription drugs is illegal—and that includes sharing prescriptions with friends.

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If prescription drugs are dangerous, why are they prescribed by doctors?

Virtually every medication presents some risk of undesirable side effects, sometimes even serious ones. Doctors consider the potential benefits and risks to each patient before prescribing medications. Doctors ask about patients' medical history, including what other health problems they have and what other medications they take. Based on this and other information (e.g., age and weight of the patient), physicians can prescribe medications while minimizing the risks. But when abused, some prescription drugs can be dangerous and can lead to severe health consequences, including addiction and overdose—just like illicit drugs can.

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Why don't people who take prescription drugs for medical conditions become addicted?

On rare occasions, they do, which is why a person must be under a doctor's care while taking prescription medications, and sometimes when stopping their use. Long-term medical use of certain prescription drugs can lead to "physical dependence" because of the way the brain and the body naturally adapt to chronic drug exposure. A person may need larger doses of the drug to achieve the same initial effects (tolerance), and when drug use is stopped, withdrawal symptoms can occur. Dependence is not the same as addiction. Addiction is when someone continues to take the drug even when they know it is severely affecting his or her life.

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Is it dangerous to abuse prescription drugs in combination with other drugs?

Yes. Both prescription and over-the-counter drugs pose increased risk of health complications when combined with other prescription medications, over-the-counter medicines, illicit drugs, or alcohol. For example, combining opioids with alcohol can intensify respiratory distress and lead to death.4

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  1. National Institute on Drug Abuse. NIDA InfoFacts: Prescription and Over-the-Counter Medications. ( Bethesda, MD: NIDA, NIH, DHHS. Published June 2009. Retrieved February 2012.
  2. Johnston, LD, O'Malley, PM, Bachman, JG, & Schulenberg, JE. (2012). Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2011. Ann Arbor: Institute for Social Research, University of Michigan. Available at
  3. National Institute on Drug Abuse. NIDA Research Report: Prescription Drugs: Abuse and Addiction. ( NIH Publication No. 11-4881. Bethesda, MD: NIDA, NIH, DHHS. Published July 2001. Revised October 2011. Retrieved February 2012.
  4. Levine, DA. (2007). “'Pharming': The abuse of prescription and over-the-counter drugs in Teens.” Current Opinion in Pediatrics. Vol. 19, No. 3, pages 270-274.
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National Institute on Drug Abuse

National Institutes of Health, U.S. Department of Health and Human Services

This material may be used or reproduced without permission from NIDA. Citation of the source is appreciated.
March 2012

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